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Putting Patients First

More and more, health systems are addressing the concept of patient-centered care and ISO is at the forefront of this development.

Industry experts expect significant changes to shake up the healthcare landscape in the next few years, which will affect both practitioners and patients. Many are the result of a shift toward value-based care, a move toward putting patients at the centre of the healthcare staffing strategy, for an all-round better quality of care. More recently, the COVID-19 pandemic has forced health systems to change, with health workers being trained in quality improvement to help support the design of new systems for the future.

Patient choice, voice and satisfaction have become focal points in healthcare. Such empowerment allows patients to make more choices about where, when and by whom medical care is received. When patients are dealing with a health issue, they are at their most vulnerable and their expectations for seamless, empathetic treatment are heightened. Thus, the real measure of good care is often the patient experience. To ensure this experience is positive, healthcare organizations need to develop a culture that places people at the centre of the care process – and that includes staffing.

The good news is that the smallest changes can make the biggest difference. Improved organizational agility, data efficiency and streamlined communication with patients and across the care team can lead directly to a better quality of care. Facilitating the transition toward patient-centred care models, ISO is working on a standard – ISO 22956 – that puts the patient at the core of the healthcare staffing strategy. Being developed by technical committee ISO/TC 304, Healthcare organization management, this timely standard outlines requisite actions for the creation of an effective staffing plan that leads to improved patient outcomes.

Staffing levels are the most important factor in being able to provide quality care.

A Patient-Centred Approach

“Patient-centred care” is a relatively new concept in the health sector, but one that has been growing in recognition over the past decade. One of the most important changes has been the gradual evolution in the way we deliver healthcare, making it a more personalized and integrated experience. The added value of ISO 22956 is its aim to harmonize terminology and best-practice classification. It will also establish management strategies and measures used by healthcare services to attract and retain the best staff. Healthcare workers are integral to the patient’s experience: they monitor, and respond to, physiological changes in health, develop care plans, deliver treatments and services, prevent adverse events, manage risks, and educate patients about care beyond the hospital.

Dr Veronica Muzquiz Edwards is CEO of healthcare staffing firm InGenesis, which develops standards under the accreditation of ANSI, ISO’s member for the USA. As Convenor of the ISO working group developing the standard (ISO/TC 304/WG 2), she explains that the group started out with one key question: How do you elevate and create a patient-centred environment regardless of setting or location? “We all know that we need consistency, oversight and standardization. This includes safe staffing levels for nurses, doctors, surgeons, social workers, therapists, technicians and pharmacy. We also know that healthcare personnel play an enormously important role in leading sustainable improvement and supporting the continuity of care.”

A patient-centred approach helps to mitigate negative consequences, particularly when staff shortages impact the outcomes of care. ISO 22956 will provide a guide for hospital managers, leaders, decision makers, risk managers and policy makers to maintain adequate staffing levels and instil a culture of patient centredness. To this end, the standard addresses all areas of staffing. This includes workforce planning, the evaluation of staffing methodologies, allocation and management of resources, as well as patient expectations and satisfaction based on collected data. It also offers guidelines for meeting statutory regulations and planning for emergency situations.

A Broad Reach

Adopting the standard will help healthcare providers improve their overall performance. Patient-centred healthcare should, in the longer term, offer greater value for money through minimizing duplication, reducing waste through improved coordination across care providers, and transparently setting priorities that take account of service cost-effectiveness and values. So who will benefit from the standard? Virtually everyone, ranging from the patients themselves to government agencies, local communities, taxpayers and funding groups, industry representatives and statutory organizations.

Dr Seun Ross is a chief nursing officer with a PhD in nursing leadership, and an active member of WG 2. She emphasizes the importance of providing guidelines on documentation and consistent measurement processes. “The development and implementation of standards, guidelines and procedures will support the organization and healthcare providers’ practice as they provide patient care,” she says.

To ensure a broad reach, ISO 22956 embraces principles of patient-centred healthcare that all stakeholders can follow. These include the traceability of patient care processes, diagnostics and therapeutics so that patients’ care pathways can be followed appropriately. Documenting procedures is an important means of securing consistent, safe and high-quality care. “Staff need to be able to access the appropriate policies and apply them effectively, increasing confidence in the quality of care provided,” she says. This will ensure that healthcare workers understand their responsibilities to the patient and the organization. It will also enable them to play a part in evaluating care and determining how it can be optimized.

Caring For Caregivers

Among the positive spin-off effects of the standard for healthcare workers, Dr Edwards cites reduced fatigue and burnout, improved staff retention and greater job satisfaction. “Organizations will also benefit from attracting, training and retaining the people they need to provide the highest calibre of medical services,” she says. Creating a workplace that actively provides appropriate premises and infrastructure, ensures the physical and psychological well-being of staff, pays a reasonable salary, and establishes fair working hours will, quite naturally, lead to improved patient satisfaction and clinical outcomes.

What’s more, career ladder programmes that reward health workers for their education, skills and leadership ability also have a positive impact on the staff retention rates and patient outcomes. “Let’s not forget what issues detract from a good working environment for healthcare professionals. To improve patient outcomes and monitor them effectively, healthcare staff also need to see genuine pathways for professional development, training opportunities and the ability to give and receive feedback to colleagues and leadership,” Dr Edwards says.

ISO 22956 doesn’t just stop at bricks-and-mortar hospitals, adds Dr Ross. Standards for patient-centred staffing can be used wherever care is provided. In fact, the standard is being designed in such a way that it can be combined with existing best-practice guidelines of key regulatory healthcare agencies in countries all around the world.

Momentum For Change

In developing the standard, ISO/TC 304 is building on existing healthcare management strategies. Now a recognized philosophy, patient-centred care is commonly accepted as the best way of providing optimal outcomes for the patient. “Approaching staffing using a ‘patient-centred’ focus was the next logical step,” Dr Ross says. “It means that all countries will recognize the approach, see how the new standard builds on this philosophy, and that it is formalized at a very high level.”

The respect bestowed on ISO/TC 304 in the healthcare sector is immense; this means the standard has the potential to be extraordinarily important, says Dr Edwards. “We know that some countries lack the infrastructure and need the framework. These guidelines will support best-practice approaches and the consistent framework will elevate healthcare around the world.”

Excitement for the standard is gathering pace. “We are seeing a lot more participation and engagement now.” There are no borders or boundaries or translation issues when it comes to patient care: Healthcare matters to all. Every country, regardless of its infrastructure or cultural issues, has experts who can contribute valuable insights to the debate. “If there’s a national standards body, there’s an expert we would love to work with, and we’ll gladly welcome their input,” Dr Edwards concludes.

For more information on ISO 22956, please visit the ISO/TC 304 page.

Disclaimer: PECB has obtained permission to publish the articles written by ISO.

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